Stuides showing B12 deficiency in PWCs

Discussion in 'Fibromyalgia Main Forum' started by deliarose, Jun 27, 2008.

  1. deliarose

    deliarose New Member

    does anyone know where I can find papers published in peer reviewed journals showing B12 deficiency in PWCs?

    Checked pubmed but i'm not familiar with it and the hits that came up were very recent and not on point.

  2. richvank

    richvank New Member

    Hi, delia.

    The only peer-reviewed paper on that topic of which I am aware is abstracted below. Note that the B12 measured in the cerebrospinal fluid was found to be low in CFS, but it was found to be normal in the blood serum. The abstract doesn't really spell the latter point out very clearly, but the full paper does.

    In CFS, the blood serum B12 is usually in the normal range or even high, rather than low. However, if methylmalonate is measured in the urine, as in a urine organic acids test, it is often found to be high, indicating that B12 is not being converted to adenosylcobalamin at a high enough rate, and that usually means that it isn't being converted to methylcobalamin at a high enough rate, either, because these pathways share their first part, which involves reaction with glutathione. So measuring urine methylmalonate is a more indicative way of determining whether a person's body is able to use B12 effectively. Unfortunately, doctors are trained to measure B12 in the blood serum.

    You asked for papers in peer-reviewed journals, but if you are willing to consider stuff from the early CFIDS Chronicles (I'm not sure how peer-reviewed it was), there were a couple of papers in 1993 and 1999 by Drs. Lapp and Cheney about B12 in CFS. They found, measuring urine organic acids, that out of 100 CFS patients, 33 had elevated homocysteine, 38 had elevated methylmalonate, and 13 had both. This was in the CFIDS Chronicle Physicians Forum, Fall, 1993, pp. 19-20.

    Here's the abstract I mentioned above:

    Scand J Rheumatol. 1997;26(4):301-7.

    Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.

    Regland B, Andersson M, Abrahamsson L, Bagby J, Dyrehag LE, Gottfries CG.
    Institute of Clinical Neuroscience, Göteborg University, Sweden.

    Twelve outpatients, all women, who fulfilled the criteria for both fibromyalgia and chronic fatigue syndrome were rated on 15 items of the Comprehensive Psychopathological Rating Scale (CPRS-15). These items were chosen to constitute a proper neurasthenic subscale. Blood laboratory levels were generally normal. The most obvious finding was that, in all the patients, the homocysteine (HCY) levels were increased in the cerebrospinal fluid (CSF). There was a significant positive correlation between CSF-HCY levels and fatiguability, and the levels of CSF-B12 correlated significantly with the item of fatiguability and with CPRS-15. The correlations between vitamin B12 and clinical variables of the CPRS-scale in this study indicate that low CSF-B12 values are of clinical importance. Vitamin B12 deficiency causes a deficient remethylation of HCY and is therefore probably contributing to the increased homocysteine levels found in our patient group. We conclude that increased homocysteine levels in the central nervous system characterize patients fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome.

    PMID: 9310111 [PubMed - indexed for MEDLINE]

  3. deliarose

    deliarose New Member

    I recently reviewed my Genova Diagnostics Metabolic Acids Profile to check on my MMA marker.

    Since this is a marker of B12 deficiency, I thought maybe I could use it to persuade my insurance to pay for my B12 shots.

    But although my level is high (17.3).. it's still within the lab reference range. (anything under 19).

    I can't fathom that at all.

    Do you understand that Rich?

    I was supplementing B12 when I ran the test, but still, I would expect it to show a deficiency.

    But it didn't, or at least not according to the lab reference range, and that's all that matters if what I read on the web is correct, because there are no universal reference ranges for MMA tests.

    It depends on the lab.


    I wonder if I ran a urine MMA off of B12 supplementation, if that would show a deficiency.

    Any thoughts anyone?

  4. richvank

    richvank New Member

    Hi, delia.

    I realize that the MAP report shows a normal range limit of 19 millimoles per mole of creatinine, but in my experience, 17.3 is a very high value for methylmalonate. It may not convince the insurance company, but it's high!

    I don't know if you could make your number go up by stopping B12. It probably would eventually go up, but in the meantime, you would also probably be shutting down your production of methylcobalamin and working against yourself as far as trying to get your methylation cycle running normally.

  5. deliarose

    deliarose New Member

    I guess it depends how long you would have to be off of B12 to see a spike?

    Another Yasko parent told me that Dr Usman thinks that the MMA rises before it falls on the yasko protocol.

    I thought that was a curious tidbit. It suggests there isn't a linear relationship.

    Can you shed any light on this? Does this tie in to Dr Yasko's observation that we need B12 to remove oxidised B12?

    [This Message was Edited on 07/31/2008]